Hooked on sugar, Mexico is the world's fattest nation and has turned to tax to fight the epidemic

Looking at the hulking teenager, Mitchell Garibay’s heartbroken family knew he was eating and drinking himself to a premature death.

At just 16 years old and standing barely five and a half feet tall, the schoolboy weighed an astonishing 22 stone – well over twice that of a healthy boy his age.

Hooked on a diet of chocolate and fizzy drinks, Mitchell and his family knew if his eating was not tackled his dependency on sugar would one day kill him. Just how quickly no one knew.

“Our diet has life and death effects on so many,” Mitchell said. “Each of us must take responsibility for ourselves, but every affordable option we have is loaded with sugar, whether it be chocolate, Coke, bread or yoghurt.

“We are not a rich nation, and the manufacturers know that. They have made us all addicts to their products and it is killing Mexico.”

The teenager is not alone, he’s just one of five million clinically obese people living in Mexico City gorging on a menu of sweets and saturated fried food known as the Vitamin T diet of tacos, tortillas and tamales.

Predominantly washed down with colossal amounts of Coca-Cola.

Mitchell Garibay weighed 22 stone at the age of just 16
(Photo: James Breeden)

Another seven million people in the capital were classed as overweight in a country which has the world’s highest death rate from chronic diseases caused by consumption of sugary drinks – nearly triple that of the runner-up, South Africa.

The obesity epidemic became so bad three years ago it took America’s crown as the world’s fattest nation.

For a country which has seen its bloody drugs war claim over 100,000 lives in the past decade, the 800,000 Type 2 diabetes has taken in the same period is sobering.

Mexico’s government were forced to take drastic action introducing a sugar tax to help combat the problem in January 2014.

Overnight one peso a litre (4p), or about 10%, charge was levied on sugary-sweetened drinks and an 8% tax on high-calorie food. It was designed to stop already poor and young Mexicans – those who suffer from obesity the most – being able to afford calorific treats.

Adults and young children consume sugary drinks and fatty fried foods directly outside the children’s hospital in Mexico City
(Photo: James Breeden)

It has also become a blueprint around the world and now the UK after Wednesday’s budget when Chancellor Philip Hammond announced details, saying money from the tax would go to the Department for Education (DfE) for school sports.

A levy of 18p is to be placed on drinks with more than five grams of sugar per 100ml, while those with eight grams or more of sugar per 100ml will have an extra tax of 24p per litre.

Around a quarter of British adults are currently classed as obese and experts predict this will rise to a third by 2025.

A report by Cancer Research UK and the UK Health Forum think tank calculated a 20% levy on soft drinks would slash obesity rates by 15% and prevent 3.7 million Britons from becoming obese in a decade.

The hope is the new tax will bring significant health benefits, cutting rates of tooth decay, obesity and type 2 diabetes, although soft drinks manufacturers say there is no evidence this will be the case.

Whoever is ultimately proved right, it will be a long road.

In Mexico City, some of the country’s most severe cases are referred to the Hospital Infantil de México Federico Gómez for acute specialist care.

The children who arrive here already have myriad health issues. Some are immediately visible, like bowed legs, while others require consultations and tests to confirm, such as diabetes, liver problems, skin lesions, metabolic syndrome, hypertension, depression and suicidal tendencies.

The sugar tax was introduced to combat childhood obesity
(Photo: James Breeden)

According to senior clinical nutritionist Betzabé Salgado, who currently handles more than 30 cases of childhood obesity, including Mitchell’s, effective treatment requires a sustained focus not just on diet and health but also on family and cultural dynamics.

She said: “In Mexico, sugar is love. Parents see how happy it makes their children and so they give it to them over and over again. There are many socio-economic reasons too including that often those who are poor cannot afford a healthy diet and the food they can buy is piled high with sugar.

“By feeding their children sugary treats such as Coca-Cola, chocolates or yoghurts they are saying to them ‘I’ll give you food because I love you’. They do not think of the damage it may be causing them.

Fizzy drinks and Coca-Cola in particular are part of the country’s national consciousness.

Everywhere you turn in Mexico City, Coca-Cola advertising on billboards and lampposts can be seen.

Every walk of life – from babies with it in their feeding bottles to the elderly carrying oversized bottles – drink ‘The Real Thing’, which at 10 pesos (40p) for a 600ml drink is cheaper than a same-sized bottle of water.

Reporter Christopher Bucktin with a bottle of Coca-Cola, which on average costs less than a bottle of water
(Photo: James Breeden)

Its low cost sees the average Mexican drinking two litres of Coca-Cola a day or 782 cans a year – 86% more than the average American. About one in every ten children are being fed soda from birth to six months and by the time they reach two it’s increased eight-fold.

Vicente Fox, who in 2000 became the country’s first democratically elected president, had earlier been president of the company’s Mexico division before becoming the head of Latin American operations for Coca-Cola, which controls 73% of the Mexican market.

Betzabé adds: “Every walk of life depends on sugar in this country. You can see children as young as two in their prams drinking Coca-Cola rather than water. It is, after all, cheaper.

“Many parents do not know if the water they have is clean for their children so given the choice they think it is safer for them to drink coke.

“The sugar tax is one part of the solution of to help tackle obesity, but it is still very early days to see how much an effect it has had.

“It is a fight we will win.”

Dr. Salgado Arroyo Betzabe is a nutritionist at the Hospital Infantil de Mexico Federico Gomez
(Photo: James Breeden)

There is no doubt it will be quite a fight, however. Now, two years on from the introduction of the sugar tax, figures show the sugar tax has helped see a 12% drop in sales of fizzy drinks.

Betzabé, whose clinics include allergists, neurologists, psychiatrists, ear, nose and throat doctors and other specialists, adds: “When the Government were looking at obesity several initiatives were created.

“One was a chart of a plate that showed children what a balanced intake of food looked like on a daily basis.

“Incredibly companies like Coca-Cola wanted their products to appear on the chart. Thankfully they did not win.”

Currently, Betzabé is treating her worst case during her 20 years at the hospital.

Schoolboy Ricardo is only seven but already weighs 14 stone – almost three times most of his friends.

Other patients include a 15-year-old girl Betzabé says is “addicted to Coca Cola”. She currently tips the scales at 15st, nearly six stone more than she should.

Betzabé said: “She has managed to kick her love of crisps, but she cannot stop herself from drinking Coke.

“She can easily drink two litres a day.”

The hospital has had to take drastic steps with many of its patients, putting them under the surgeon’s knife to have gastric sleeves fitted. The youngest recipient was a 15-year-old girl.

Mitchell has lost a huge amount of weight since having a gastric sleeve fitted
(Photo: James Breeden)

Mitchell also had one fitted in December 2013 when he was at his heaviest.

“I was nervous about it,” he explained, “but it has helped me suppress my appetite. I still have trouble eating chocolate, but I don’t have fizzy drinks as much. It has helped me shed almost six stone in weight.

“If ever there was an example to Britain’s politicians over whether they should act or not, we are it.

“The question they need to ask themselves is who is more important, people or profits? Don’t make the same mistake our country did for years.”

According to research by Mexico’s National Institute of Public Health, together with the America University of North Carolina, in the first year, the tax reduced consumption of sugary drinks by an average of 6% over the 12 months, reaching 12% by the end of last year.

But the drinks industry disputes the figures.

“We did an analysis with the National Institute of Statistics and Geography and what we have, until June 2015, is that consumption and sales have been affected by one or two per cent,” says Jorge Terrazas of Mexico’s bottled drinks industry body, Anprac.

Shopkeepers in Mexico City seem to agree with the industry describing any drop in sales as “unnoticeable”.

Eva Martha Del Toro Gonzalez, 41, whose shop is festooned with paid-for Coca-Cola signs, and free fridges said: “It is a dirty war fought by these companies.

“People think the Cola cartels are as ruthless as those run by drug lords, the only difference is they get them hooked on drinks not drugs.

“We have not seen much of an effect on our sales of their drinks.”

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